Target $82
Thursday, January 5, 2023
NYC Hospitals Start Moving Sick Babies, Diverting Ambulances as Nurse Strike Looms
Time is running out, with just four days left until a possible New York City nurses' strike at multiple major local hospitals — and one of the city's largest hospital systems is starting to take drastic measures.
But in a possible glimmer of hope, two more hospitals reached deals with the union Wednesday night, potentially putting pressure on the others to settle.
Until then, Mount Sinai Health System is beginning to divert "a majority" of ambulances from four of its facilities, and is transferring babies from its neonatal intensive care units to other hospital systems, according to a memo from hospital leadership to staff, a copy of which was obtained by News 4.
The memo from the leaders of Mount Sinai Hospital, Mount Sinai Morningside and Mount Sinai West makes clear that most issues in the ongoing negotiations have been resolved - but not all, and the clock is ticking.
"To do what is best for our patients, we have no choice but to proceed with our strike planning," the memo says, outlining a series of steps:
- Diverting ambulances from Mount Sinai Hospital, Mount Sinai West, Mount Sinai Morningside and Mount Sinai Beth Israel
- Cancelling elective surgeries, and scheduling only emergency surgeries at the main and Morningside facilities
- Transferring some patients. "In addition, this - sadly - means transferring NICU babies outside the Mount Sinai Health System to ensure they get the care they so desperately need."
- Discharging "as many patients as appropriate" and shifting services - inpatient care at the main and West facilities, and emergency and child psychiatry at the Morningside campus
"Nurses feel abandoned and disrespected by their bosses," New York State Nurses Association president Nancy Hagans said. "We held the hands of dying patients, set up last FaceTime calls so dying patients could say goodbye to their loved ones."
Seven private hospitals (Montefiore, Mount Sinai Hospital, Mount Sinai Morningside and West, Maimonides, BronxCare, Richmond University Medical Center and Flushing Hospital Medical Center) are on notice for a potential strike starting the morning of Jan. 9 — a move that would send already busy hospitals into full-on crisis mode, and potentially have a devastating impact on care.
The union said Thursday morning that deals were struck Wednesday night at Maimonides and Richmond, leaving the other five still pending.
Each of the hospitals negotiates individually with their own nurses, so depending on how talks go, there could be no strikes at all, a single strike or as many as seven strikes.
"It could be an enormous public health calamity," Ken Raske of the Greater New York Hospital Association previously told NBC New York. He has described the mood as among hospital managers as "extremely apprehensive."
The nurses union said there has been at least one sign of progress: All of the hospitals on the list except for Flushing Hospital have agreed to not cut health benefits.
"There has been some offers and progress but we are not there yet," said Hagans.
As of Wednesday, all eyes are on New York-Presbyterian Hospital and the nurses there. There was a tentative deal reached over the weekend that, if accepted, would give nurses 18 percent raises over the next three years, with added incentives to retain experienced nurses. There was also a promise to address chronic understaffing, which was the union's biggest complaint.
But there is a large caveat: NY-Presbyterian is widely considered to be the richest hospital in the city, and not all hospitals are in the same financial situation. While all the hospitals have said they are negotiating in good faith, some said they can't afford to pay as much — a big sticking point considering some hospital executives are paid in the millions.
Smaller so-called "safety net" hospitals are more reliant on lower reimbursement rates for the care they provide, like through Medicare or Medicaid. Some of the others on the list say they are hemorrhaging money, but nurses at those hospitals aren't buying the argument.
According to a source familiar with Mount Sinai's past talks, the hospital had previously offered nurses a deal that included 14 percent raises over four years — a deal that nurses rejected, and that was noticeably lower than the offer extended by NY-Presbyterian.
"It's not really up to us whether we walk out. It's up to the bosses," said Hagans.
While it remains to be seen whether the nurses at NY-Presbyterian will accept the offer, Montefiore Hospital said Wednesday that nurse representatives at their hospital had rejected a deal that mirrored the one NY-Presbyterian offered. A spokesperson for the hospital said that nurses were offered "an 18 percent wage increase over three years, fully funded healthcare for life, and a significant increase in registered nurses in the emergency departments, among other benefits."
That development may spell trouble for other hospitals given the financial landscape. According to the Montefiore spokesperson, NY-Presbyterian posted $200 million in profits in 2022 while Montefiore posted $200 million in losses. That sort of deal was considered potentially unattainable for other hospitals on the list, but now nurses at NY-Presbyterian may think twice about ratifying the deal they tentatively agreed to (voting began Tuesday night and concludes Saturday).
Gov. Kathy Hochul's office has said previously that they are "monitoring the situation." Sources said that both Hochul and NYC Mayor Eric Adams are getting regular daily updates on the talks. While the hospitals involved are all private, meaning neither Hochul nor Adams have any formal role, some have wondered whether they would step in to apply pressure or try to broker a deal.
NBC New York has learned that the other hospitals that have not reached agreements with their nursing staffs are starting to shell out tens of millions of dollars in nonrefundable down payments to have traveling temporary nurses on reserve — a huge expense they must shoulder, even if no strike takes place.
The GNYHA said doing so works against the interest of the nurses in the union because it forces hospitals to spend money that could go to the nurses — but it also increases the leverage of nurses once the strike notice is issued. One nurse involved in negotiations estimated the cost of trade nurses is around $10,000 a week per travel nurse. The New York State Nurses Association estimated that the mere threat of a strike has already cost as much as $32 million to temp agencies, a cost they said could surge to more than $90 million if the travel nurses have to fill in for five or six days.
"Our ERs are backed up, the tripledemic is raging," said Raske. "Even if one hospital would have a strike, it could ripple through the entire system."
The New York State Nurses Association has as many as 12,000 members threatening to conduct strikes at seven respective hospitals where contracts expired on Dec. 31.
The union says members are upset about staffing ratios at the local hospitals, contract proposals that they feel dramatically worsen their healthcare benefits (while paying big bonuses to executives), and Mayor Adams' recent move to forcibly hospitalize psychiatric patients. All of those elements have left workers overworked and burnt out.
"We're not able to clean the patient on time, not able to give medicine on time, no breaks," said Allen. "Burnout was real, so we leave the profession and go to work at a travel agency that's going to pay us more."
In a statement Monday, a spokesperson for Mount Sinai said that their bargaining teams "continue to make good-faith efforts to pursue a contract with NYSNA that is fair to our community and responsible with respect to the long-term financial health of our organization. Mount Sinai nurses deserve the best possible working environment, wages, and benefits, and we're tirelessly pursing these to all our employees' advantage."
The statement added that the hospital system is "prepared for staffing changes, and we will do our best to ensure our patients' care is not disrupted and will do everything possible to minimize inconvenience to patients."
The average salary for nurses in New York is $93,000, and $98,000 in NYC, nurses union and the GNYHA confirmed. However, there is a big disparity between nurse pay in private vs public hospitals, where salaries are almost $20,000 less.
All of this comes as the city deals with what is being called a tridemic - simultaneous and serious spikes in infections with COVID, the flu and the respiratory condition RSV.
The city has already issued an advisory (but not a mandate) suggesting that people go back to wearing masks indoors.
Hamlin ‘awake’ and showing ‘remarkable improvement’ after terrifying collapse
The Bills and the NFL got the Damar Hamlin update they were waiting for.
The team said in a statement Thursday morning that the Bills safety is “neurologically intact” and has “shown remarkable improvement over the past 24 hours.”
Hamlin collapsed in the first quarter of the Bills’ game against the Bengals on Monday and was administered CPR on the field after he stopped breathing. Hamlin was rushed to University of Cincinnati Medical Center, where he remains in the ICU.
The Bills said that he remains “critically ill” but “his lungs continue to heal and he is making steady progress.”
“Our boy is doing better, awake and showing more signs of improvement. Thank you God. Keep the prayers coming please. All love 3!” Bills cornerback Kaiir Elam tweeted.
According to NFL Network, Hamlin is “responsive” and has gripped the hands of those close to him.
https://nypost.com/2023/01/05/damar-hamlin-awake-and-showing-remarkable-improvement/
Twitter Data Breach: Hack Put 200 Million Users' Private Info Up For Grabs
by Prashant Jha via CoinTelegraph.com,
The hacker had demanded $200,000 to return the breached data back in December but warned that if their conditions are not fulfilled, they will release the data for free...
200 million Twitter users’ private information, including their email addresses, was put for sale after a breach exposed 400 million users’ private information in the last week of December 2022.
The hacker behind the December breach had earlier demanded $200,000 from Twitter in a bid to return the stolen data and warned if the demand is not fulfilled, the data will be released for free. The latest set of data posted on the hacker forum has been traced back to the same breach from December 2022.
Researchers at Privacy Affairs confirmed that the leaked data set on the hacker forum is the same from December. The 200 million number, in this case, resulted from the removal of duplicates. The released data set doesn’t contain phone numbers. The researchers warned that these data sets could be used to initiate social engineering or “doxing” campaigns.
The data set was originally 63GB, but after removing duplicates and compressing the files, the size of the latest data set was reduced to 4GB and free to download.
The hacker also noted that the analysis of original file dates and account creation dates “strongly suggest” that this was collected from early November 2021 through December 14, 2021.
Many users on Twitter demanded that the social media platform looks into security as these hacks put activists and whistleblowers in danger.
Some of the popular and known names and entities include Sundar Pichai, Donald Trump Jr., SpaceX, CBS Media, the NBA and the WHO. The data breach vulnerability has been patched now. But, tracing back to the hack, it seems the same vulnerability was used for another exploit in July 2022.
Chindex Medical Acquires 10 ViewRay MRIdian Systems for Advanced Cancer Treatment
Purchase agreement with ViewRay will make state-of-the art precision radiation therapy available in China
ViewRay, Inc. (NASDAQ: VRAY) announced today that Chindex Medical Limited (Chindex), through its subsidiary, has ordered 10 MRIdian® MR-Guided Therapy Systems. Chindex, a subsidiary of Shanghai Fosun Pharmaceutical (Group) Co., Ltd. (Fosun Pharma), has been ViewRay's distribution partner since 2019. MRIdian received regulatory approval in September 2022 from the National Medical Products Administration (NMPA), allowing for its sale and utilization throughout China. This approval expands MRIdian's global reach and offers cancer patients a new radiation therapy option, MRIdian Stereotactic MRI-Guided Adaptive Radiotherapy (SMART).
https://finance.yahoo.com/news/chindex-medical-acquires-10-viewray-144100578.html
Eisai questions link between lecanemab and patient death
With the FDA due to deliver a decision of Eisai and Biogen’s new Alzheimer’s disease candidate lecanemab tomorrow, the safety of the drug has been thrust into the spotlight by a case report detailing a fatality in one of their clinical trials.
The write-up of an autopsy of a patient who died whilst being treated with lecanemab – published in the New England Journal of Medicine – raises concerns about a possible interaction between the Alzheimer’s drug and tissue plasminogen activator (tPA), used to treat ischaemic stroke.
News of the death of the 65-year-old woman, who was receiving lecanemab as part of the CLARITY-AD trial, first emerged in November shortly after the top-line results from the study were revealed. It was the second fatality linked to cerebral haemorrhage from the study, with an earlier case involving a male patient treated with lecanemab and anticoagulant therapy Eliquis (apixaban).
The letter to the NEJM penned by researchers from the Northwestern University Feinberg School of Medicine notes that the latest death took place in a female patient who was participating in an open-label extension phase of the CLARITY-AD trial, and it is not known whether she received lecanemab or placebo during the main study.
Four days after receiving a third dose of the anti-amyloid antibody, she arrived in hospital with stroke symptoms, and was given t-PA, but subsequently suffered multiple cerebral haemorrhages that led to her death.
According to the researchers, the “extensive number and variation in sizes of the cerebral haemorrhages in this patient would be unusual as a complication of t-PA solely related to cerebrovascular amyloid.” Although, they acknowledge fatal bleeds have been seen after t-PA therapy in some patients in the absence of anti-amyloid drugs.
The big question for Eisai and Biogen – given that the Alzheimer’s population tends to be elderly and at increased risk of stroke – is whether there is an interaction between lecanemab and t-PA that raises the risk of brain bleeds.
Eisai is adamant that there is no clear evidence for that, though it acknowledged that the case report “raises important management issues for patients with Alzheimer’s disease.”
In a response to the letter, also published in the NEJM, it said, “although t-PA appears to be the proximate cause of death, this was an unusual case,” adding that the report is consistent with a known increased risk of haemorrhages in people with cerebral amyloid angiopathy, a condition in which amyloid is deposited in the walls of blood vessels in the brain.
Last month, the influential Institute for Clinical and Economic Review (ICER) in the US concluded that the evidence for lecanemab in Alzheimer’s – including a statistically significant 27% slowing of cognitive decline with the compared with placebo in CLARITY-AD – was “promising but inconclusive”.
https://pharmaphorum.com/news/eisai-questions-link-between-lecanemab-and-patient-death/
JP Morgan 2023
For most people, the name “JP Morgan” means bankers and investors. But for the pharma sector, it means meetings all over town in San Francisco and presentations by anybody who’s anybody in pharma, life sciences, and, increasingly, digital health. Back in the Golden City after a few years of COVID-enforced virtuality, JPM Week is more than just the exclusive closed-door conference it’s named for – it also includes a smattering of satellite events and, of course, thousands of one-on-one meetings between pharmas, biotechs, investors, and journalists.
This JP Morgan week we’ll have Editor in Chief Jonah Comstock on-site covering the Neuroscience Innovation Forum, Fierce JPM Week, the Informa Biotech Showcase, STAT@JPM, and more. Other pharmaphorum reporters will remotely cover key presentations from the main event. And, as for those 1-on-1 meetings, we’ll be bringing them to you in the form of video interviews after the conclusion of the week.
Check in here Sunday through Tuesday for updates from JP Morgan and more. And then come back to our video section for more throughout the winter.
JP Morgan 2023 – Pre event coverage coming soon
JP Morgan 2023 – Day 1 coverage coming soon
JP Morgan 2023 – Day 2 coverage coming soon
JP Morgan 2023 – Day 3 coverage coming soon
JP Morgan 2023 – Day 4 coverage coming soon
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